Bill Klaproth (Host): This is an AAOMS On the Go podcast. I'm Bill Klaproth. In today's episode, we explore the pivotal role of Oral and Maxillofacial Surgery Faculty in nurturing a culture of advocacy among residents. Joining us are two esteemed faculty members of OMS Residency Programs who share their insights, strategies, and success stories in promoting advocacy within the field.

First off, we have Dr. George Kushner, Chair of the Department of OMS at the University of Louisville. Welcome, Dr. Kushner.

Dr. George Kushner: Thanks, Bill. I'm glad to be here.

Host: I'm happy to have you here. And we also have with us Dr. Kelly Kennedy, Program Director at The Ohio State University. I want to make sure I say that right. Dr. Kennedy, welcome.

Dr. Kelly Kennedy: Thank you, Bill. I appreciate that introduction of the university, and excited to be here.

Host: Yeah, thank you. And I want to thank you both for your efforts in shaping the future of oral and maxillofacial surgery. Very important. So, I want to thank you both for being here today. Dr. Kushner, let me start with you. Why do you believe advocacy is so crucial for the future of oral and maxillofacial surgery?

Dr. George Kushner: Thanks, Bill. I'm glad to chime in with this. Oral and maxillofacial surgeons do a tremendous service for our communities, our state, and our regions, but not a lot of people know exactly what we do, and I think it is critical for us to let our communities know what we do for them. For example, I know here at Louisville, and I know at Ohio State where Dr. Kennedy is, the oral surgeons are part of the trauma center, both for adults and the child population, the pediatric population. And I know we both provide trauma care for some of the most horrendous injuries in our communities. At the academic healthcare centers, we take care of the most difficult and most vulnerable patient populations. And most people just really aren't aware of that. I think the average person thinks of the oral surgeon as the person that pulls out their children's wisdom teeth. But we are so much more, and I think it's incumbent upon us to get that word out, because like it or not, all specialties have to deal with outside forces, outside influences. And one of the most important things we can do is let the outside world, the outside influences and those people know exactly what we do and how important we are in our communities.

Host: Yeah. Dr. Kennedy, thoughts?

Dr. Kelly Kennedy: Yeah. I mean, I 100% echo everything Dr. Kushner just said. I mean, you know, as OMSs, we live a great life taking care of patients with these pretty critical needs, and legislation really can change that, and overnight, if we let it. So, I think developing relationships with lawmakers, legislators, with other organizations, healthcare organizations that may influence the way that we practice and deliver care to patients is critical. And so for that long road, really developing those close-knit relationships so that we can continue to advocate for our specialty and our patients moving forward.

Host: Yeah, advocacy is so crucial. And like you say, Dr. Kushner, good to let the know the community what you do for them. And Dr. Kennedy, as you say, there's so much that you do. It's good to let all the stakeholders know this, and start to develop those relationships, and let everybody know what the specialty does. So Dr. Kennedy, let me stay with you. What specific roles do OMS faculty play in fostering a culture of advocacy among residents since advocacy is so important?

Dr. Kelly Kennedy: Yeah, that's a great question to bring up. I think first just defining it, defining what advocacy is to your trainees. It's certainly not something that comes innately to all individuals or citizens of the country necessarily. I mean, these are kids that are working hard, spending lots of time taking care of patients and reading and preparing for conferences and courses, and it’s not – advocacy  – isn't necessarily in their forefront. So, I think it's just reminding them what it is, that it's relationship building, It's educating people as to what OMSs do and what kind of services that they provide to patients. So really, it's just the visibility of it. You know, bringing back – I'm sure Dr. Kushner does the same thing when he's doing some work with in particular to advocacy, is bringing it back to the residents and talking about it and making those efforts visible.

Host: Dr. Kushner, your thoughts on that?

Dr. George Kushner: I couldn't agree more, and Kelly and I have some very similar thoughts, and I think one of the major roles we do is leading by example. I think the faculty have to be involved in advocacy at the local level, at the state level, and at the national level. And so, this requires you being active, being a player locally. Positions in your hospital, when the governor comes to our Level 1 Trauma Center, I always get invited. I've met the governor. On a state level, there's many ways to be active through OMSPAC, through our Political Action Committee. You know, we've delivered checks to some of our local politicians. So, we try to be active like that.

And then also, every year, I try to go to the Day on the Hill. I've been many, many times to Washington, D.C. for the AAOMS Day on the Hill. And so, the residents see their faculty taking the time to participate locally at your institution, in your community, in your city, but also in a state and national level. And then, they start asking questions. And we talk about this in our weekly rounds the importance of these things. And we try to foster a culture of advocacy early in their career. Some of them catch on and get it and are all on board. Some don't, but I think you have to at least lay the groundwork for the importance of advocacy with your residents.

Host: Yep, absolutely. Laying that groundwork is so important. And like you say, there's many opportunities to be involved and to play a part, local, state, national, as you say. Dr. Kennedy, can you share some examples of efforts that you've personally participated in when it comes to advocacy efforts?

Dr. Kelly Kennedy: Sure, Bill. I'd happy to. You know, one of the things that I was very fortunate to have around me when I first started out as an oral maxillofacial surgeon, once I was done with training, was a lot of mentors, people that had already been good advocates for our special specialties. Something I did very early on was started to attend the executive committee meetings for the Ohio Society of Oral and Maxillofacial Surgeons, so our state society. And anybody that shows an interest and attends meetings tends to get tagged to start serving on some committees and kind of taking some of these smaller steps to really learning what advocacy is.

So eventually, through those efforts, I got elected to the vice president of our state society, which of course ascends to being the president, and that was an amazing learning experience. And it can sound quite intimidating, but the process is built – right? – on kind of a graduated learning scale to where you're learning as you go. You don't have to know how to run and be the president of a state society, so it's getting started early in little bits and chunks here and there.

Also, Day on the Hill, as Dr. Kushner mentioned, you know, really spending time with our federal legislators and seeing "how the sausage is made." But probably, the bigger takeaway from those Day on the Hill events when you're spending time with your Congresswomen and men is that you see that we are such a small little population, that they hear from on a daily basis. It's even more important that we get our voice out there to them.

Additionally, the grassroots efforts, you know, that AAOMS really fosters with Voter Voice, getting an email, a call to action by the governmental affairs office, and clicking a link and sending letters off to your state and federal legislators. So, all very quite simple things that you can get involved with that make a big difference.

Host: And Dr. Kushner, how about you? Some examples of some of the things you've been involved in.

Dr. George Kushner: You know, to be a good advocator, you have to be involved. And there are so many ways to be involved, locally, state, and on a national level. And I have been fortunate like Kelly, I was mentored, I had great mentors that got me involved early, and I realized that it was important. It certainly takes time. It'll be an evening where you can go home with your family, or you have to go and have dinner with a political person in your state, in your region, in your city, going to these different meetings. But I think it pays huge dividends.

And so, on the weekends, you can play golf with your buddies or you may have to do a fundraiser, you may have to be involved with recently a trauma survivors event at our institution, at our university hospital, where we brought trauma survivors back in. And a bunch of the politicians came by and we were talking about the wonderful services that are provided at our university hospital.

And again, to me, this is all advocacy saying, A, what healthcare is doing in our city, in our state, in our region, how Oral and Maxillofacial Surgery is involved in this big, complex puzzle of healthcare. And so, I actually enjoy it. I have derived a lot of pleasure out of spreading the joy of oral and maxillofacial surgery to other healthcare providers, the lay public, politicians, administrators, you name it. But I am quite proud of our specialty. And every chance I get to, I guess, espouse the glory of oral and maxillofacial surgery, I take advantage of it because we do a tremendous service to our patients in our cities, in our states, in our regions, and all over the world actually.

Host: Yeah. Well, you're a great advocate for the specialty. And again, we appreciate that, both of you. So you’re talking about the joy. You love this, Dr. Kushner, and you were talking about how you want to spread the joy and all of the great things that the specialty does. How do we integrate that joy and the importance of advocacy into the OMS residency curriculum and instill this knowledge, this joy in the next generation of surgeons, Dr. Kushner?

Dr. George Kushner: Well, you lead by example, Bill. And so, you have to be involved, and we talk at our weekly teaching rounds about this. And I think the residents can pick up if this is like, “Oh you know this is something that's important for us to know,” and "Geez, why is Dr. Kushner meeting with the administration at University Hospital about Trauma Survivors Night?" And so, I think you have to be in the trenches. And the residents, quite honestly, can see this. And then, they start to pick up and follow your lead. So, I think the people ahead of me were quite active and really enjoyed it. They took me under their wings. I got to see how this worked, and I am a firm believer, and I try to lead by example. I want the residents to know that I'm in the thick of things, and I'm not just giving it lip service. This is stuff that I do, and I enjoy it.

Host: Yeah. But you're talking the talk and walking the walk, as they say, leading by example. And Dr. Kennedy, how about you? Your thoughts on instilling this knowledge in the next generation of surgeons?

Dr. Kelly Kennedy: Yeah, you know, as far as how to really integrate the importance of advocacy, I think that sometimes the trainees don't realize that they're already being great advocates for oral and maxillofacial surgery. I mean, anybody that has spent time in a hospital setting with other surgical services understands that they too think that wisdom teeth is about the extent of our surgical services that we offer. So the residents are going around the hospital educating other teams, other types of healthcare providers as to what it is that we can do for patient populations and building relationships with those other specialists. It's much easier to get some interdisciplinary help with a patient by already having existing solid relationships. So they're already doing it. They just need to understand that they need to continue that on into their professional career to really protect this wonderful specialty that we have.

Host: Yeah, I like that. Protect the specialty. I did a podcast interview the other day and a person said defend the specialty, so like the words that you use there. And it starts early, as you say. So, Dr. Kennedy, what strategies do you use then to encourage residents to participate in advocacy efforts? What are some of the things you've personally done to encourage people?

Dr. Kelly Kennedy: You know, Bill, I just try my best to make it real to them. Like I said before, these are busy individuals. So, I just try to bring home real-world examples where it does matter to them. Advocacy is not the "political stuff." You know, it's apolitical. We work with individuals on both sides of the aisle, so to speak. But I make it real to them by helping them understand how it might influence their careers.

So, you know, in particular right now with the REDI Act, the Resident Education Deferred Interest Act. This is an act to try to get deferment of interest while medical and dental residents are in training, because there's a lot to be said about the amount of loan burden that these trainees are coming out of their training with. And that really does influence where and how they might be able to practice. And I think it's important for them to understand that there are legislators and lobbyists and their faculty and private practitioner OMSs, they're out there fighting for these causes and educating and building relationships.

Additionally, a lot of the procedures that we're able to do in practice and how we are paid to do those procedures come down to federal rates that are given through Medicare. And those rates are directly reflected in the private insurances. So, it's all intertwined, it's all important. And so, just trying to make it quite real to the residents.

Host: Yeah. I like how you say you try to make it real, and you said you try to show them how advocacy efforts can impact their career, and why it's important to get involved, as you say. That's really good stuff. And Dr. Kushner, how about you? How do you personally encourage residents to become more involved in advocacy efforts?

Dr. George Kushner: Very similar to Kelly, I get them involved. And we talk about these things at our teaching conferences. I'll print out the article about the proposed Medicare cuts. And we talk about what does this mean to you. And I show them that I write letters. You know, AAOMS is very good about encouraging their members to speak their peace. You know, your voice counts. I'm also a member of the American College of Surgeons. They're very active politically. But I think a lot of the docs just kind of get wrapped up in their own little world. And there's a much bigger picture out there. And like I said, we talk about these things on a weekly basis.

We talk about the practice of oral and maxillofacial surgery, how it's being affected. What can I do? And then, like in the hospital, we get them involved on committees. We get them involved spreading the goodwill of oral surgery. So as faculty, we get asked to give some lectures and we certainly do that within the hospital to the nurses, to our anesthesia colleagues, to our surgery colleagues, to the dental school, but we also get our residents involved with them. So they're interfacing and people are seeing the specialty of oral and maxillofacial surgery from the residents, from the faculty, from the attendings. So I get them involved.

Host: Yeah. Kind of surrounding them, getting them from all angles, it sounds like. And then, Dr. Kennedy, you mentioned mentors earlier. How important is mentorship in developing engagement among residents, Dr. Kennedy?

Dr. Kelly Kennedy: You know, it's critical. And Dr. Kushner and I have both mentioned this already, that you have to see people doing it, right? So, to really bring it home. And, even ROAAOMS, the resident organization within AAOMS, reports that trainees are most influenced by their faculty. We joke sometimes at our graduation events that the trainees have spent more time with us in their training period than they have with their family. And why not take advantage of some of that influence, right? So, do all of the things that we've been talking about and make it visible and real to the residents, and that's where the mentorship really is just super critical.

Host: Yeah, Dr. Kushner was saying lead by example, and you just said you have to see people doing it, you have to kind of show them the way. Dr. Kushner, your thoughts on mentorship and developing engagement among residents?

Dr. George Kushner: Bill, it's absolutely critical, and I was fortunate enough to have great mentors, and they showed me the importance of being active, being a player, participating. And to me, it was never work. And so I was on board. So my mentors led by example and really the residents will see through it if I come in and say, you know, "You do this, you do this, you do this," but I don't do any of that stuff. They can see through that very quickly. And they want to see their faculty members being active, you know, holding positions in state organizations and within the hospital being on committees making a difference, and then talking about this at rounds, at our teaching rounds. We talk about this, why is this important?

And yes, it takes time. Yes, it takes effort. But dividends are huge because people now know what we do as a specialty, who we are, what we do. And so, I think the mentorship is so critical. It just facilitates you becoming a good advocate, a player, in our specialty.

Host: And like you say, the dividends are huge, and that is a very, very true statement. Okay. So from both of you, Dr. Kennedy and Dr. Kushner, where does someone get started? What advice would you give to new OMS faculty members who want to promote advocacy in their programs? Dr. Kennedy, let's start with you. Okay, so you've got a resident, they want to get started. How should they start? What do they do?

Dr. Kelly Kennedy: Yeah. So I guess, you know, just get involved in little bits here and there, whether it be on a local level or state or national, there are pretty low intensity, time-wise, ways that you can get involved that we've talked about through this podcast. So that would be the first start. But then, if you're trying to get new faculty members to really advocate in their programs, the faculty members need to be consistent with that message year-round. Not just using the governmental affairs email as a reminder to talk about it in your programs. But really, to be very consistent about it keep it right in the faces of trainees, so to speak.

Host: Yeah, that makes sense. And Dr. Kushner, how about you? Where would you suggest someone starts if they want to get involved in advocacy?

Dr. George Kushner: Very similar to Kelly. Small steps. Start small. But it's being active. And yes, it's going to take some time at the end of the day instead of going to the gym or going home to your family. It may take some time on the weekends. But there are so many avenues to get involved, so many ways to get involved.

And I would just say get active. I mean, look at your emails, things pop up. If people are looking for a committee to look at this, to look at the ER time backups and how can we fix this. You just get involved. And once you're involved, it becomes a little bit more second nature to you. And then you can start to really get good at ways to make a difference in your community, in your local hospital, in your community, in your state. But it's a bit of a snowball effect. You know, every journey starts with a single step. And I guess that's my advice, is when you get there, take that step, get involved, and then look around you. There's people out there that are willing to help. There's a huge resource out there with our colleagues, not only within oral and maxillofacial surgery, but in all of medicine.

So I think there are strength in numbers within the specialty of oral and maxillofacial surgery, but within healthcare itself. So all you have to do is take that step, get involved, and my prediction is that it will snowball for you. And, like I said, I derive pleasure out of this. I really look forward to trying to make a difference, and telling everybody the glory of oral surgery, what we're doing for our patients, what we're doing for our communities, our state, and on a national level.

Host: Yeah. Every journey starts with a single step. I love that. So thank you for that, Dr. Kushner. I want to thank you both for your time today. This has really been informative, hearing both of your journeys with your advocacy efforts. Final question to each of you. Dr. Kennedy, let's start with you. Final thoughts, anything you want to add when it comes to promoting advocacy within the field?

Dr. Kelly Kennedy: Yeah. Just a reminder to those that are listening that it really is up to us as individuals to take little steps, little bits of advocacy for our specialty. We can't leave it to others to really determine what our specialty looks like in 15, 20 years. So you're in it for the long haul. Let the snowball effect happen like Dr. Kushner said, and let's keep our specialty great.

Host: Yeah. It's up to us as individuals, little steps, and it's so important that everybody get involved to help chart the course of the future of the specialty. Dr. Kushner, final thoughts from you. Anything else you want to add when it comes to promoting advocacy within the field?

Dr. George Kushner: If everyone did a little bit, it would be easier for everybody. The natural tendency when I look is that people say, “Ah you know, I'm too busy” or “I don't want to do that.” But I think if everybody pitched in a little bit, became a little bit more involved in your local community, in your state, in your region. And being involved, there's just so many ways. Writing a letter about the proposed Medicare cuts. Contributing to a political action committee. There again, so many ways to get involved, and if everybody did a little bit, it would be so much easier for everybody.

Host: I love that. If everybody did a little bit, it would be so much easier for everybody. What a great final thought, Dr. Kushner. Thank you for that. Dr. Kennedy and Dr. Kushner, I want to thank you very much for your time today. This has really been informative. Thank you again.

Dr. Kelly Kennedy: Thank you, Bill.

Dr. George Kushner: Bill, thank you. Kelly's a dear friend of mine, and it's always a pleasure to interact with her, and I always enjoy her company and her thoughts.

Dr. Kelly Kennedy: I second that, George.

Host: And once again, that is Dr. George Kushner and Dr. Kelly Kennedy. And for more information and for another place to start, quite frankly, just go to AAOMS.org/Advocacy. That's AAOMS.org/Advocacy. And if you found this podcast helpful, please share it on your social media channels and don't forget to subscribe. Thanks for listening.